RESEARCH REPORT © 2004 Society for the Study of Addiction Addiction, 99, 103–108 Blackwell Science, LtdOxford, UKADDAddiction1360-0443© 2003 Society for the Study of Addiction to Alcohol and Other Drugs 98Original ArticleJavier Ballesteros et al.Brief interventions for hazardous drinkers Correspondence to: Javier Ballesteros Universidad del País Vasco Dpto Neurociencias Barrio Sarriena s/n 48940 Leioa Spain Tel: + 34 94 601 2799 Fax: + 34 94 464 9266 E-mail: onpbaroj@lg.ehu.es Submitted 25 October 2002; initial review completed 25 February 2003; final version accepted 6 June 2003 RESEARCH REPORT Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women Javier Ballesteros 1,2 , Asunción González-Pinto 1 , Imanol Querejeta 3,4 & Julen Ariño 5 1 Universidad del País Vasco, Dpto Neurociencias, Leioa, 2 Instituto de Investigaciones Psiquiátricas, Bilbao, 3 Hospital Donostia, Servicio de Psiquiatría, San Sebastián, 4 Universidad del País Vasco, Escuela Universitaria de Trabajo Social, San Sebastián and 5 Módulo Psicosocial Deusto-San Ignacio, Bilbao, Spain ABSTRACT Background Despite the accumulated evidence on the efficacy of brief inter- ventions in hazardous drinkers some ambiguity remains regarding their differ- ential effectiveness by gender. Methods Meta-analysis of independent studies conducted in primary health care settings with a follow-up of 6–12 months which report results separately by gender. Two outcome measures were selected: the quantity of typical weekly alcohol consumption and the frequency of drinkers who reported consumption below hazardous levels after the intervention. Results Seven studies were included in the meta-analysis. The standardized effect sizes for the reduction of alcohol consumption were similar in men (d = - 0.25; 95% CI = - 0.34 to -0.17) and women (d = - 0.26; 95% CI = - 0.38 to - 0.13). The odds ratios (OR) for the frequency of individuals who drank below harmful levels were also similar (four studies; OR for men = 2.32; 95% CI = 1.78–2.93; OR for women = 2.31; 95% CI = 1.60–3.17). The difference between genders was negligible. Conclusion Our results support the equality of outcomes among men and women achieved by brief interventions for hazardous alcohol consumption in primary care settings. KEYWORDS Brief intervention, effectiveness, hazardous drinkers, meta- analysis, men, women. INTRODUCTION A decade of systematic reviews has supported the effec- tiveness of brief interventions to reduce excessive levels of alcohol consumption in non-dependent individuals (Bien, Miller & Tonigan 1993; Kahan, Wilson & Becker 1995; Wilk, Jensen & Havighurst 1997; Poikolainen 1999; Moyer et al. 2002). Nevertheless, some room for ambiguity remains regarding possible differential effec- tiveness between genders of these interventions because the evidence so far gathered is imprecise on this issue. The landmark study directed by Babor & Grant (1992) finds a significant effect of brief interventions among men but not among women who show decreased consumption in both intervention and control groups. Evidence from pre- vious meta-analyses is also inconclusive. Whereas Kahan et al. (1995) state in their meta-analysis that results among women were much less impressive than results for men, Wilk et al. (1997) describe slightly greater effects of brief interventions in women. More recently, Poikolainen (1999), despite reporting effect estimates of the same magnitude for both sexes, also describes significant het- erogeneity of results, although this did not allow a direct comparison between genders. Finally, the review by Chang (2002) does not quantify effect sizes between genders. To clarify the impact of brief interventions in men and women who drink excessively, including both hazard- ous—drinkers beyond safe limits—and harmful drink- ers—those who have already incurred alcohol-related damage—but do not have a diagnosis of alcohol depen- dence, we meta-analysed a set of independent studies